{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:43:50Z","timestamp":1780109030372,"version":"3.54.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The circadian rhythm of myocardial infarction (MI) in patients with obstructive sleep apnea (OSA) remains disputable and no studies have directly evaluated the relationship between nocturnal hypoxemia and the circadian rhythm of MI. The aim of the current study was to evaluate the association of OSA and nocturnal hypoxemia with MI onset during the night.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with MI in the OSA\u2010acute coronary syndrome (ACS) project (NCT03362385) were recruited. The time of MI onset was identified by patient's report of the chest pain that prompted hospital admission. All patients underwent an overnight sleep study using a type III portable sleep monitoring device after clinical stabilization during hospitalization. The difference in circadian variation of MI onset was evaluated between patients with moderate\/severe OSA and non\/mild OSA and those with or without nocturnal hypoxemia. Nocturnal hypoxemia was evaluated using 3 variables, including oxygen desaturation index, minimum oxygen saturation, and total sleep time with saturation &lt;90%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Among 713 patients enrolled, 398 (55.8%) had moderate\/severe OSA (apnea\u2010hypopnea index \u226515 events\u00b7h\u2009\u2212\u20091). Compared with the non\/mild OSA group, the MI onset was significantly increased in the moderate\/severe OSA group between midnight to 5:59\n              <jats:sc>am<\/jats:sc>\n              in 6\u2010hour epochs analysis (26.9% versus 18.4%,\n              <jats:italic>P<\/jats:italic>\n              =0.008). Only in patients with both moderate\/severe OSA and nocturnal hypoxemia, including oxygen desaturation index \u226515, minimum oxygen saturation \u226486%, and total sleep time with saturation &lt;90% \u22652%, the incidence of MI onset between midnight to 5:59\n              <jats:sc>am<\/jats:sc>\n              was significantly increased. Moderate\/severe OSA (adjusted odds ratio 1.66 [95% CI, 1.13\u20132.43];\n              <jats:italic>P<\/jats:italic>\n              =0.01) and nocturnal hypoxemia (oxygen desaturation index \u226515 model, adjusted odds ratio 1.80, [95% CI, 1.21\u20132.66]; minimum oxygen saturation \u226486% model, adjusted odds ratio 1.70 [95% CI, 1.16\u20132.47];\n              <jats:italic>P<\/jats:italic>\n              =0.006; total sleep time with saturation &lt;90% \u22652% model, adjusted odds ratio 1.54 [95% CI, 1.04\u20132.27];\n              <jats:italic>P<\/jats:italic>\n              =0.03) significantly predicted MI occurrence from midnight to 6:00\n              <jats:sc>am<\/jats:sc>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A peak of incident MI onset between midnight to 5:59\n              <jats:sc>am<\/jats:sc>\n              was observed in patients with moderate\/severe OSA, especially in those presenting with nocturnal hypoxemia.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036729","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T11:21:59Z","timestamp":1737976919000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Association of Obstructive Sleep Apnea and Nocturnal Hypoxemia With the Circadian Rhythm of Myocardial Infarction"],"prefix":"10.1161","volume":"14","author":[{"given":"Xiaochen","family":"Liu","sequence":"first","affiliation":[{"name":"Center for Coronary Artery Disease, Division of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Coronary Artery Disease, Division of Cardiology 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